Provider Demographics
NPI:1487675633
Name:SAGUIL, ENRIQUE G (MD)
Entity type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:G
Last Name:SAGUIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 GRAND CANYON PKWY STE 214
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1735
Mailing Address - Country:US
Mailing Address - Phone:847-454-7021
Mailing Address - Fax:844-622-7040
Practice Address - Street 1:10240 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2880
Practice Address - Country:US
Practice Address - Phone:219-703-2420
Practice Address - Fax:219-703-6765
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90245207Q00000X
IL036-088279207QS0010X
IN01092609A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300086644Medicaid
F97864Medicare UPIN